Breakthrough in Deep Brain Stimulation Surgery

February 17, 2020

It was one of those moments that changes everything. Lori Marble was getting ready for work one morning when she fell down the stairs.

“I have a condition called hemidystonia,” she said. “What often happened was the left side of my body just wouldn’t get the signal that the rest of my body was moving. So, my left leg stayed in the kitchen, and the rest of me went down the stairs.”

The coffee mug she’d been holding in her hand broke, cutting into her leg. Her glasses cut into her head. Those injuries were probably a good thing, because they were what prompted her to go to the emergency room at Mercy Hospital Joplin – where she learned she had a brain bleed.

Dr. Sami Khoshyomn, a Mercy neurosurgeon who works in both Springfield and Joplin, urged Marble to see one of his new colleagues, Dr. Kevin Mansfield, in Springfield. He felt certain Mansfield would know what to do to treat Marble’s dystonia.

“Honestly, I think I agreed to the appointment because Dr. Sami is so nice,” Marble said. “I’d been told nothing could really be done for my dystonia. Specialists had told me I’d probably end up using a walker and eventually a wheelchair.”

Instead, Dr. Mansfield did have a solution. “He walked in and he’s very approachable and calm and he looked me up and down and said, ‘You have dystonia, and I can fix it.’ I was like, alright.”

Hear from Lori and Dr. Mansfield about Deep Brain Stimulation (DBS) Surgery

Dr. Mansfield proposed deep brain stimulation (DBS) surgery. He would implant a device to send electrical signals to the brain to help regulate Marble’s movements. It’s a treatment that’s become known for treating Parkinson’s disease.

But Dr. Mansfield offered a big twist on the usual procedure. He’s one of the few surgeons in the country who can perform DBS surgery while the patient is asleep. “Knowing I wouldn’t have to be in a panic throughout the surgery was great. I was like, ‘just put me to sleep,’“ Marble said.

Dr. Mansfield says having the patient asleep reduces anxiety for everyone. “It makes the patient feel better, it makes us feel better, and everyone in the room is more relaxed. We tend to have at least as good – probably better – results doing it this way. Most patients go right to sleep, wake up in the recovery room with maybe a slight headache, and get to eat dinner that night, and usually go home the next day.”

To prepare for the surgery, Dr. Mansfield used high-resolution scans of Marble’s brain to plan exactly where he would place the electrode. During the surgery, he used three-dimensional navigation equipment to ensure he hit the right spot. “I can tell within less than a millimeter how accurate the placement is,” he said. “I can move it while we’re in the operating room if I need to.”

After surgery, Marble went home for a week, then came back for a quick outpatient surgery to have the battery implanted in her chest. It was about another month of healing before Dr. Mansfield turned on the unit to see what it would do.

“Beforehand, if I were to walk down this hallway, I would walk like I’d had several drinks,” Marble remembered. “When they turned it on, I strutted it like I was a runway model. I even wanted to do the little finger snap! I turned around, and everyone was in tears.”

Marble says the surgery has truly changed her life. “Before, none of us trusted me to hold or to walk any distance with our newborn granddaughter. Who would? I’m not going to risk that. And now, that’s OK. And that’s huge. It’s amazing how well it’s worked.”

Lori Marble with her granddaughter, Poppy. Since getting deep brain stimulation surgery, Marble is now able to hold Poppy without worry. Lori Marble with her granddaughter, Poppy. Since getting deep brain stimulation surgery, Marble is now able to hold Poppy without worry.